> Conclusions and relevance: Our cross sectional study in both COVID-19 out- and inpatients strongly suggests that daily smokers have a very much lower probability of developing symptomatic or severe SARS-CoV-2 infection as compared to the general population.
> Very recently, the US Center of Disease Control reported an analysis of current smoker rate among US COVID-19 patients which was found to be 1.3% for the whole population of COVID-19 patients, 1% for outpatients, 2% for patients, not hospitalized in an ICU, and 1% in intensive care unit (ICU)-admitted patients
https://www.qeios.com/read/WPP19W.3
in all of the mentioned countries, only about 1% of ICU cases are smokers. this has (perhaps unsurprisingly) not been widely reported.
Seriously though, it's baffling because smoking causes so many underlying health problems that don't go well with COVID. Also, smokers have a depressed immune system compared to nonsmokers, so it would seem to suggest they'd be less likely to fight off an infection like this.
Being a smoker has been a standard part of your medical history for a long time now for obvious reasons. There's no reason to think there is a coordinated strategy for lying about smoking in the context of a pandemic (much less revising patient medical histories, which would be the medical service industry lying).
50%+ lying about smoking in the face of potential (or actual) respiratory failure is laughable.
I don't know where you got 50%+. The outpatient group was 5.3% current smokers vs expected (adjusted for age and sex) 26.9%. For inpatient it was 4.4% vs expected 17.9%. The fact that both groups had the same reported rate of current smokers (within experimental error) but very different expected rates says to me that you're only getting the people who are honest or simply incapable of quitting even while sick.
Also, see this concern brought up:
> Finally, and I believe this to be the most significant piece of data supporting the null hypothesis, the prevalence of never-smokers in the general population is approximately 0.75, if one subtracts the smoking incidence rate from 100. In your patient groups, non-smokers are strongly under-represented by about a factor of 2 relative to the general population, with 31% of outpatient and 32% of inpatient being labeled as never-smokers. This suggests to me that any amount of smoking actually puts one at risk for contracting COVID-19 as defined by this paper.
In any case, many other studies of COVID-19 have found similar results, and studies of different respiratory diseases have not. I'd initially just thought people were lying too, but at some point the evidence becomes overwhelming--if the protective behavior were anything but smoking, then people would have accepted it long ago.
Of course smoking is far deadlier on average than the coronavirus, per my calculation elsewhere in this thread. No one should start smoking because of this, but I do see enough evidence e.g. that a nursing home patient (who's at very high risk of death from coronavirus, and likely to die of something else before smoking-related diseases could develop) shouldn't quit. Vaping probably gets any benefit with almost none of the health risk, though that's speculative.
1. http://beh.santepubliquefrance.fr/beh/2019/15/pdf/2019_15_1....
If most people that have severe COVID complications and end up on the ICU are aged 80+, and generally smokers die before that age from smoking-related complications, doesn't it naturally follow that most people on the ICU will be non-smokers? Smoking will have killed the smokers before they become part of the high-risk group, after all.
Here is a quote from the abstract of the paper linked above:
> Results: The inpatient group was composed of 343 patients, median age 65 yr: 206 men (601%, median age 66 years) and 137 women (39.9%, median age 65 years) with a rate of daily smokers of 4.4% (5.4% of men and 2.9% of women).The outpatient group was composed of 139 patients, median age 44 years: 62 men (44.6 %, median age 43 years, and 77 women (55.4 %, median age 44 years). The daily smokers rate was 5.3% (5.1% of men and 5.5 % of women). In the French population, the daily smokers rate was 25.4% (28.2% of men and 22.9% of women).
The average daily smoker rate is taken as-is over the whole population, and compared to the smoking rate of people of age around ~66 years, despite the article itself stating that the percentage of daily smokers is lower for old people and higher for young people.
So already in the abstract they have made a mistake and forgot to correct for age. I have not read the rest of the article in enough depth to judge fully, but I would absolutely not blindly trust researchers to always do this correction in an appropriate way.
>smokers with a positive Covid-19 test were more than twice as likely as non-smokers with coronavirus to be hospitalised.
> This aligns with research from the US which found hospitalised smokers with coronavirus were 1.8 times more likely to die.
is contradicted by the study showing that smokers with covid are more likely to have severe symptoms than non-smokers with covid.
While a lot of people are skeptical of the official numbers from these countries, I think they have free media and if cases were high, we would have known.
They also said elsewhere that a lot of researchers from outside epidemiology are running really bad studies and publishing papers.
Even with conservative assumptions, smokers in this French study were 4 to 5 times less likely to be infected.
Keep in mind that drugs being tested are considered good when they reduce mortality by 10%. We're talking 75% reduction in infection rate here, and no increased mortality in those who are infected. It's really really hard to imagine what sort of confounding factor that could be at play here that would make the effect insignificant.
They give nicotine patches to nurses in pilot studies, how ironical :D
Edit: I had that wrong, it seems nicotine increases ACE2, but also binds with ACE2 decreasing the amount of available enzymes overall that COVID could bind to.[2]
[0]https://en.wikipedia.org/wiki/Angiotensin-converting_enzyme_... [1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191112/ [2]https://arxiv.org/abs/2004.14943